Decentralization and privatization in Portuguese health reforms

ABSTRACT - The Portuguese National Health Service (SNS), a universal, centralized and public owned health care system, exhibits an extraordinary record of equalization in the access to health care and health gains in the late thirty years. However, the most recent history of the Portuguese health reform is pervaded by the influence of decentralization and privatization. Decentralization has been present in the system design since the 1976 Constitution, at least in theory. Private ownership of health care suppliers and out-ofpocket expenditures, on the financing side, both have a long tradition of relevance in the NHS mix of services. The initial aim of this study was to demonstrate expected parallelism between health reforms and public administration reforms, where a common pattern of joint decentralization and privatization was observed in many countries. Observers would be tempted to consider these two movements as common signs of new public management (NPM) developments. They have common objectives, are established around the core concepts of gains in effectiveness, efficiency, equity and quality of public services, through improved accountability. However, in practice, in Portugal, each movement was developed in a totally separated way. Besides those rooted in the NPM theory, there are few visible signs of association between decentralization and privatization. Decentralization, in the Portuguese SNS, was never intended to be followed by a privatization movement; it was seen merely as a public administration tool. Private management of health services, as stated in the most recent SNS legislation, was never intended to have decentralization as a condition or as a consequence. Paradoxically, in the Portuguese context, it has led invariably to centralized control. While presented as separate instruments for a common purpose, the association between decentralization and privatization still lacks a convincing demonstration. Many common health care management stereotypes remain to be checked out if we want to look for eventual associations between these two organizational tools.

Basel III: The impact of new capital requirements on profitability of Portuguese Banks

This empirical study aims to explore the impact of increased capital ratio requirements, on the ROE of the Portuguese banking sector. The paper employs both a quantitative- and qualitative approach, with the qualitative approach as the main method of research. The method adopted to conduct the qualitative research was semi structured elite interviews with banking executives. Higher capital requirements decrease the ROE of banks in Portugal, but huge impairments charges, macroeconomic factors and increased costs of deposits are clearly the dominant reasons for the reduced levels of ROE the past years. Among the measures taken to increase capital ratios, reduction of RWAs and non-core assets have been the main focus, but the issuance of CoCos is regarded as the most expensive measure due to high interest payments. However, the CoCos will not have any effect on the ROE in the long term. It is difficult to draw any conclusions on the impact of more equity in the balance sheet on the ROE of Portuguese banks, as many banks currently don’t generate enough money to pay back on shareholders´ investments.

Recommendations for Nova School of Business and Economics to target yhe Colombian market

The growing connotation Internationalization has worldwide, alongside the economic, political and socio-environmental changes, is empowering a progressively global education economy. Therefore, this Work Project aims to help Nova SBE to understand the decision making process of the Colombian tertiary education students, as this market constitutes an enriching opportunity to meet both business and educative objectives. In order to do so, a qualitative research was conducted to comprehend the rationale behind Colombian students to study abroad. The study points out that the reputation of a HE institution and the Portuguese culture are the key attributes to pursue a degree in Portugal.

Monte Carlo valuation of worst-of auto-callable equity swaps

This thesis proposes a Monte Carlo valuation method for Worst-of Auto-callable equity swaps. The valuation of this type of swap usually requires complex numerical methods which are implemented in “black-box” valuation systems. The method proposed is an alternative benchmark tool that is relatively simple to implement and customize. The performance of the method was evaluated according to the variance and bias of the output and to the accuracy when compared to a leading valuation system in the market.

Innovative medicines in the portuguese private health sector

The present dissertation aims at contributing to a strategic view over the use of innovative medicines in the portuguese private health sector, as a way of being complementary to public system that nowadays finances most of the innovative medicines. With the rationalization of expenses in the public health sector, pharmaceutical companies tend to look for opportunities of expansion to the private sector. The creation of innovative financial models for the private sector to cover innovative treatments is the proposed way of surpassing the restriction on the NHS sales of innovative medicines. This can be both for differentiating private health providers from the NHS or for the creation of premium services that can be differentiated from other private providers of the portuguese market.

How to optimize the business model for ConsultaClick an innovative startup in the e-health Portuguese sector

Field lab: Entrepreneurial and innovative ventures

Re-evaluation of central America drug market where to start?

Atral is a Portuguese Pharmaceutical firm devoted to the production of finished drugs. Due to domestic market hurdles, Atral is now, more than ever, focused in the world. The Central America region seams alluring due to its context alignment with firm’s resources bundle. As Atral should approach one regional country at a time, the purpose of this thesis is to find out the most suitable country to approach now. Hence a tailored scoring model was applied, based on contexts analysis and importance of benchmarking indicators to both firm and industry. Upon analysis of the highest scored country, the most appropriate entry modes were assessed.